(93) Melatonin Use Among Children, Adolescents, and Young Adults: A Danish Nationwide Drug Utilization Study

Publication Number: 1138

Background: Melatonin was formally approved for treatment of insomnia in Danish children and adolescents with specific disorders in 2018 and is available by prescription only. Still, melatonin use among children and adolescents has increased over the last decades, although potential long-term consequences of melatonin use in this age group are unknown.

Objectives: We aimed to describe melatonin use in Danish children, adolescents, and young adults and provide a detailed description of users during 2012-2019, in order to understand the general increase in use.

Methods: Using the Danish nationwide health registers, we identified all Danish individuals aged ≤24 years, who filled at least one melatonin prescription during 2012-2019. For each individual, we extracted data on filled prescriptions of melatonin and other psychotropic drugs, hospital contacts, diagnoses of psychiatric disorders, contacts to private practicing psychiatrists, as well as information on specialty of prescriber.

Results: We identified 34,652 melatonin users (median age 16 years) during 2012-2019. The incidence of use increased from 2.4 to 3.9/1,000 person-years during those years. In 2019, 53% of incident users filled only a single prescription within the first 6 months after melatonin initiation. Long-term use of melatonin was most common among the younger age groups, with 17% of 5-9-year-olds and 14% of 10-13-year-olds being in continued treatment (no treatment breaks) for at least 12 months after their first melatonin prescription. Disregarding treatment breaks, the equivalent proportions were 63% in 5-9-year-olds and 51% in 10-13-year-olds. Psychopathology was common among young melatonin users with 75% registered with either a psychiatric disorder diagnosis (54%), a filled prescription for another psychotropic (58%), or a contact to a private practice psychiatrist (15%) within ±12 months of melatonin initiation. General practitioners prescribed melatonin to almost half of all new users (48%) while psychiatric specialists accounted for 37%.

Conclusions: The incidence of melatonin use increased in Denmark from 2012-2019. A substantial proportion of melatonin users had concurrent psychopathology most likely explaining their use of melatonin. Long-term melatonin use was more common among the youngest age groups, which should be a focus of interest due to limited safety data.